Individual
RENEE A BREAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.T.C
Contact information
Practice address
JOHNSON STATE COLLEGE, 337 COLLEGE HILL, JOHNSON, VT 05656
(802) 635-1487
(802) 635-1497
Mailing address
47 PEACHTREE LN, APT. 1, COLCHESTER, VT 05446
(802) 373-5270
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1040000093
VT
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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